Cuban rebels had been fighting a war of independence against Spain since 1895, and the United States had crept slowly from neutrality to possible intervention on behalf of the insurgents. The U.S. battleship Maine lay at anchor in Havana’s harbor as a show of protection for U.S. citizens. On 15 February 1898, the ship exploded, killing 260 men and rousing the public to a fever pitch for war. Congress and President William McKinley declared war on 22 April.
The U.S. Army was not prepared for war. In 1898, it was limited to 25,000 soldiers scattered among military schools and frontier posts. Nothing larger than companies, batteries, battalions, and regiments formed the army’s organizational structure. On 23 April, McKinley called for 125,000 volunteers, which he eventually raised to 182,000 men, to augment the Regular Army soldiers. The Army Hospital Corps, with 983 men, although well- trained, was insufficiently manned to provide medical care for the thousands of wartime patients.1
During the heightened tensions after the Maine explosion, and before the declaration of war, women had volunteered to serve as nurses for the Army and Navy. Surgeon General George M. Sternberg had opposed the introduction of women, believing that females in the field would need expensive and unnecessary luxuries such as bureaus and rocking chairs. Once assured that female nurses would demand no special privileges, Sternberg committed himself to employing women as nurses if war ever came. After the declaration of war, both trained graduate nurses and untrained women flooded the government with applications.2
Dr. Anita Newcomb McGee, serving as Vice-President General of the Daughters of the American Revolution (DAR), had persuaded Sternberg before the war that any nurses used must be educated professionally. She formed the DAR Hospital Corps Committee, which established stringent criteria for selecting female graduate nurses and provided a pool of highly trained nurses for both the Army and the Navy. On 27 April, McGee offered her services and those of the DAR Hospital Committee to General Sternberg,3 which he accepted the following day in a letter, saying: “I appreciate very highly the offer of the national board of management of the Daughters of the American Revolution, and am quite willing to turn this whole matter over to your committee. . . .”4
On 28 April, Sternberg requested permission from the Secretary of War to hire an unlimited number of male or female nurses, under contract but without military status, and to provide them $30 a month and one daily ration. No women had served in the Army as nurses since the Civil War; existing legislation, dating from the 1860s, had provided only 40 cents a day (about $12 a month) and one ration a day. On 29 April, Sternberg established the Nurse Corps Division to manage the military nursing requirement and placed McGee in charge. On the following day, the Secretary of War provided Sternberg the hiring authority he had requested and, on 7 July, Congress passed the Deficiency Bill that authorized the monthly pay.5
By 30 April, the Army had received 1,000 applications from zealous women and was thankful to be relieved of the burden of review. Moreover, the DAR Hospital Corps Committee acquired the responsibility to review all applications from women desiring to be nurses for the military, “whether addressed to the President, the Secretaries of War and Navy, or the respective Surgeon Generals [sic].”6
The Washington press delighted in McGee’s role as director of the DAR Hospital Corps Committee, praising her as “young and charming, possessing unusual magnetism, vivacity, and a gift of language.”7 She was 34 years old, wife of a prominent Navy officer and scientist, daughter of an internationally renowned astronomer, and a mother. In addition, McGee was a recent graduate of Columbian College’s medical school, frequent board member of the DAR, lecturer, scientist, and writer. Her brilliant intellect provided the vision, and her social connections gained her the influence toward accomplishing her goals.8 McGee considered herself to be a “new woman.” She believed firmly in women’s abilities to combine marriage, motherhood, and career.
McGee and her volunteer staff worked in a small office in Washington, D.C., examining between 5,000 and 8,000 applications that poured in from across the nation. They also had to contend with visitors who besieged their office, inquiring after their applications. The DAR officers worked from 0800 until 2300 at the daunting task of tackling this voluminous correspondence and the requirement to select those who were fit to be military nurses from those who were not. Once a woman offered her services via letter, McGee’s committee sent an application asking her age, previous work experience, whether she had ever been exposed to yellow fever, and whether she was strong and healthy. Persons who had survived yellow fever developed an immunity to the disease, and officials were deeply concerned about encountering it in Cuba in the summer months. An accompanying letter notified the applicant that, if selected, she would receive rail fare to her assignment, $30 a month, and one ration a day but would be expected to pay for her lodging unless the Army provided it. Additionally, the notification advised the applicant of her possible assignment to Navy shore duty.9
McGee and her staff judged applicants on their professional ability, character, and health. Though McGee believed that Army nurses should be nurse training school graduates, she sometimes dropped this requirement when she urgently needed nurses for a particular theater, particularly if the nurse had an immunity to yellow fever. At least three-quarters of the contract nurses who served were graduates of nursing schools. Originally, applicants had to be between the ages of 30 and 50, but so many younger women clamored for appointments that this criterion was removed. Approved nurses were placed in a reserve and, when the military required a certain number of nurses, the DAR Hospital Corps Committee sent Army contracts, transportation tickets, and orders to those selected. Once a woman signed a contract with the military, however, the DAR’s official connection with that nurse ended.10
Sternberg submitted his first request for female nurses on 5 May. The first six Army nurses signed their contracts on 10 May and traveled to their assignments in Key West. The Surgeon General’s office soon was swamped with administrative work related to the nurses, such as transferring them between hospitals, and it identified a need for a knowledgeable individual who could be paid to carry out these tasks." When testifying before Congress after the war, McGee stated: “As I was the person having the greatest knowledge of this work, and as it was impossible for a volunteer to conduct it, the Surgeon General appointed me as acting assistant surgeon. He then believed that the contracting with fresh nurses was about at an end, and therefore, on September 7 the Daughters of the American Revolution were relieved, with thanks, from further duty in connection with this office.”12
Sternberg appointed McGee Acting Assistant Surgeon on 28 August, the first woman ever to serve in such a high official position in the military. He always referred to her as Acting Assistant Surgeon Anita Newcomb McGee and to her organization as the Nurse Corps (female) in his official correspondence with the War Department. McGee, however, signed her papers, “In charge, Army Nurse Corps.” In 1899, she published the first Army regulation on the Nurse Corps, increasing a nurse’s monthly pay to $40 in the United States and $50 when serving overseas. The regulation also defined a nurse’s duties and privileges, such as quarters, rations, transportation expenses, leave, sick care, uniform, and badge, and served as the model for the nursing corps until 1947.13
A total of 290,000 men served in the military during the war, but most did not ship out to Cuba or anywhere also. The greatest number of soldiers spent the hot summer months in southern states, in crowded, filthy, unsanitary training camps in which disease ran rampant. Disaster struck with a vengeance as men fell captive to malaria, typhoid, dysentery, and diarrhea, before ever encountering the enemy soldier. Once the soldiers arrived in Cuba, yellow fever, or “yellow jack” as it was commonly known, exacerbated the already deadly problem of disease. By July, the Army experienced a sick rate of 20%; by August, it had climbed to 30%. The mortality rate reached 5.69 per 1,000 in September. The military desperately needed nurses, but the 6,000 men recruited by 31 August for that purpose were only half of what was needed, and most of them were untrained and unmotivated. The Army had resorted to pulling infantrymen from their units to serve in the wards and, because commanders only gave up their least desirables, the quality of medical care plummeted even further.14
Sternberg drastically increased the numbers of women serving in military hospitals and also sent them overseas. Nurses often worked from 0700 to 2100, taking only 20 minutes for lunch and 20 minutes for dinner.15 Their sleeping quarters were overcrowded and primitive but, as one nurse commented, “it made no difference to us that we were 40 to 50 in a shack when off duty, just room enough to stand between the cots” because of “how grateful the boys were for [our] services.”16 One nurse, who was stationed in Puerto Rico, described how they drove to camp in ambulances pulled by mules, hauled water in barrels for more than a mile, tended patients in crowded tents filled with typhoid fever, dysentery, and diarrhea, and had no access to ice or diet kitchens. The military had no uniforms for women so nurses wore their nursing school outfits, demonstrating at a glance the dozens of nursing schools they represented at any military camp. At Sternberg Hospital, Camp Thomas, 91 training schools had graduates working as contract nurses for the Army.17
The cases the women faced required skilled nursing care 24 hours a day. Some typhoid victims had backs that appeared to be one large bed sore. In order to administer the ice baths these men needed several times a day, nurses trudged back and forth between the icehouse and the hospital. The ill men required special nourishment, sufficient fluids, and a high-protein, low-roughage diet every two hours. Most nurses cared for 40 to 50 patients at a time, and counted themselves fortunate if they had the assistance of even one medical corpsman.18 Sternberg Hospital was a collection of 13 primitive huts and, as one nurse stated: “The soiled clothing and bedding had to be taken care of and we had no way or equipment to handle it, so as to reduce to a minimum the danger of infection for us. We had no disinfectant whatsoever to use. There was not even one wash basin in these wards for the nurses to wash their hands. At one time there was a shortage of water for several days [and] we were requested ‘not to wash at all.’”19
The nurses themselves could not avoid infection, and yet, according to Major E. C. Carter, an Army surgeon at Camp Thomas, in a letter to McGee on August 18: “These nurses are very zealous—they over-work themselves from the highest and best motives and many of them take it awfully to heart when they are stopped and to be invalided away is very bitter to them. Now I have to send a number to the Mountains every week to recuperate. Now if I could hold out to these unselfish women the prospect of similar work in a more bracing climate I’m sure they would not be so distressed at having to go away.”20
Twelve nurses eventually died from typhoid fever and one from yellow fever as a result of their war service.
Early in the war, Sternberg recognized that the military would need a hospital ship to evacuate soldiers from Cuba once military operations began. The Navy purchased the USS Relief in May 1898, outfitting it with 750 beds and all medical equipment and supplies needed for six months at sea. The upper two decks of the ship contained the hospital wards as well as an operating room and the latest technological equipment—a large X- ray machine. Six women nurses comprised part of the ship’s hospital staff, which had a full complement of doctors and corpsmen. McGee requested Esther V. Hasson, who later became the first Superintendent of the Navy Nurse Corps, to serve aboard the Relief, which sailed from Tampa, Florida, for Cuba on 3 July. The Relief arrived at Siboney, Cuba, on 15 July, shortly after the battle for San Juan Hill on 1 July and the defeat of the Spanish Navy on 3 July. For the next two months, the nurses cared for 1,234 patients with yellow fever and other diseases and 251 with battle wounds. Sixty- one of their patients died, with 80% of the deaths stemming from disease. After the Spanish surrendered Santiago on 17 July, the U.S. forces continued to weaken. Of the 20,000-man force in Cuba, by 27 July one-quarter were afflicted with yellow fever, malaria, or typhoid. The War Department immediately sent a medical contingent that included 729 female nurses to Santiago.21
Outside Havana, a camp was established that began to study how yellow fever was transmitted. Clara Louise Maass, one of the first contract nurses, died in 1901 while willingly undergoing a yellow fever experiment under Dr. Walter Reed’s supervision. She permitted herself to be bitten several times by mosquitoes that had first bitten yellow fever victims. Maass died after contracting a virulent attack of the disease, proving that mosquitoes carried yellow fever; she was buried with full military honors. The U.S. Postal Service issued a stamp with her likeness that simply said, “Clara Maass. She gave her life.”22
Following the war, Sternberg told Congress: “American women may well feel proud of the record made by those nurses in 1898-1899, for every medical officer with whom they served has testified to their intelligence and skill, their earnestness, devotion and selfless service.”21 The congressional committee investigating the War Department’s conduct of the war stated: “Those who have been serving under contract in our military hospitals, and there have been about fifteen hundred of these, have with scarcely an exception done excellent work.” The “indisputable contribution of the contract nurses convinced Sternberg that nurses should be a permanent part of the Army medical system, despite the prevalent belief of many men that no women should be granted military status.”24 Although most of the contract nurses had been under Army control, confusion had resulted when others were paid by the Red Cross or the DAR. McGee and others wanted to eliminate this possibility in the next war and began work on securing a permanent Army Nurse Corps. After initial attempts by professional nursing organizations failed, McGee’s proposed legislation passed.25
In the Army Reorganization Bill of 2 February 1901, Congress created the Nurse Corps (female) as an auxiliary of the Army and a permanent branch of the Army Medical Department. The Corps would include only fully trained nurses from hospital schools who would receive letters of appointment in the Army for three years and could apply for reappointment. The nurses still had not received military status—they had no military rank, no pay equal to male officers, no retirement benefits, and no veterans’ benefits. Those obstacles would remain for several decades. Professional nursing organizations, fearful that McGee would be the first Superintendent of the Nurse Corps, pushed for legislation requiring a trained graduate nurse at its helm. After choosing her successor, Dita H. Kinney, McGee resigned on 31 December 1899. On 28 February 1901 the newly instituted Nurse Corps consisted of 202 charter members.26
After the war, McGee founded the Society of Spanish- American War Nurses, remaining its president for six years, and assisted her nurses in eventually obtaining veterans’ benefits for their services in the war. A memorial to the nurses was dedicated in Arlington National Cemetery in 1905. McGee helped write the legislation that established the Navy Nurse Corps in 1908. The Air Force Nurse Corps was established in 1947 by the National Defense Act. Since 1967, the DAR has awarded the Dr. Anita Newcomb McGee Award to a deserving Army nurse.27
Military nurses also have served in combat conditions in World War I, World War II, Korea, Vietnam, and Desert Storm, as well as humanitarian missions around the globe. Millions of U.S. Soldiers, Sailors, Airmen, and Marines, their families, and people worldwide have experienced improved health and a boost in morale from the skilled and dedicated care they received from McGee’s nurses, whether they were contract nurses of 1898 or modern military nurses on the eve of the 21st century.
1. Graham A. Cosmas, An Army for Empire: The United States Army in the Spanish-American War (Columbia, MO: University of Missouri Press, 1971; reprinted Shippensburg, PA: White Mane Publishing Co., 1994), pp. 14, 109; Frank Burt Friedel, The Splendid Little War, (Boston: Little, Brown & Co., 1958), p. 34; Lucy Ridgely Seymer, A General History of Nursing (New York: Macmillan Co., 1933), p. 124.
2. Cindy Gurney, “Anita Newcomb McGee (1885- 1904),” (Washington, DC: Army Nurse Corps Archives, Center of Military History, February 1986), p. 4.; Edith A. Aynes, From Nightingale to Eagle: An Army Nurse's History (Englewood Cliffs, NJ: Prentice- Hall, 1973), p. 225; Elizabeth A. Shields, ed., Highlights in the History of the Army Nurse Corps (Washington, DC: Government Printing Office, 1981), pp. 9-11; Lavinia L. Dock et al., History of American Red Cross Nursing (New York: Macmillan Co., 1922), p. 36; Grace L. Deloughery, History and Trends of Professional Nursing, 8th ed. (St. Louis: C. V. Mosby Co., 1977), p. 75.
3. “Another First for DAR: The Dr. Anita Newcomb McGee Award,” The Daughters of the American Revolution Magazine (March 1967), p. 248; Patricia M. Donahue, Nursing, The Finest Art: An Illustrated History, illus., ed., and comp, by Patricia A. Russac (St. Louis: C. V. Mosby Co., 1985), p. 327; Lyndia Flanagan, One Strong Voice: The Story of the American Nurses’ Association (Kansas City, MO: Lowell Press for the American Nurses’ Association, 1976), p. 34; Isabelle M. Stewart and Anne L. Austin, History of Nursing: From Ancient to Modem Times, A World View, 5th ed. (New York: G. P. Putnam’s Sons, 1962), p. 204; Minnie Goodnow, Outlines of Nursing History, 6th ed. (Philadelphia: W. B. Saunders Co., 1939), pp. 192-93; Philip A. Kalisch and Beatrice J. Kalisch, The Advance of American Nursing, 2nd ed. (Boston: Little, Brown &. Co., 1986), pp. 231-32; Ellen Condliffe Lagemann, ed., Nursing History: New Perspectives, New Possibilities (New York: Teachers College, Columbia University, 1983), pp. 19-20; Mary M.Roberts, American Nursing: History and Interpretation (New York: Macmillan Company, 1955), pp. 28-29; Lena Dixon Dietz, History and Modem Nursing (Philadelphia: F. A. Davis Co., 1963), p. 140; Deloughery, p. 75; Dock et al., p. 36.
4. P. M. Ashburn, A History of the Medical Department in the United States Army (Boston: Houghton Mifflin Co., 1929), p. 207.
5. Dock et al., pp. 37, 46; Deloughery, p. 75.
6. Congress, Senate, “Reply of the Surgeon General to the Comittee: The Selection of Female Nurses,” Report of the Commission Appointed by the President to Investigate the Conduct of the War Department in the War with Spain, 56th Congress, First Session, 1899-1900, Series 3865, XXIII, no. 221, vol. 1, pp. 725-26; Congress, Senate, Testimony of Anita Newcomb McGee, Report of the Commission Appointed by the President to Investigate the Conduct of the War Department in the War with Spain, 56th Cong., 1st sess., 1899-1900, Series 3865, XXIII, no. 221, vol. I, p. 3173; Kalisch and Kalisch, p. 232.
7. Newspaper article, 17 May 1898, Anita Newcomb McGee (ANM) Papers, R.G. 112, National Archives, Washington, D.C.
8. Anita Newcomb McGee (ANM) Papers, Manuscript Reading Room, Library of Congress, Washington, D.C.
9. Kalisch and Kalisch, pp. 232, 234; Donahue, p. 327; Flanagan, p. 34; Senate, “Reply of the Surgeon General,” p. 726; Lagemann, p. 20; Roberts, p. 29; Stewart and Austin, p. 204; Congress, Senate, Daughters of the American Revolution, Second Report of the National Society of the Daughters of the American Revolution, 11 October 1897-11 October 1898, No. 425, p. 1900.
10. Senate, “Reply of the Surgeon General,” p. 726; Lagemann, pp. 19-20; Dietz, p. 180; Donahue, 327; Flanagan, p. 34; Senate, McGee Testimony, p. 3173; Kalisch and Kalisch, p. 234.
11. Aynes, p. 226; Kalisch and Kalisch state request occurred on 7 May, p. 234; Dock et al., p. 41; Donahue, p. 327; Senate, McGee Testimony, p. 3173.
12. Senate, McGee Testimony, p. 3173.
13. Although Dr. Mary Walker served as an assistant surgeon in the Army during the Civil War, her position was not similar to Anita McGee’s. McGee’s position is usually titled Assistant Surgeon General. Assisting the Surgeon General, working in the War Department, and signing documents and orders on the Surgeon General’s behalf were McGee’s responsibilities as assistant to the Surgeon General. Walker, on the other hand, was an assistant surgeon in the field, tending to patients as part of a hospital staff. She was assistant to a surgeon but not to the Surgeon General. Dock et al., p. 42; Aynes, pp. 20, 226; Senate, McGee’s Testimony, p. 3173; Senate, “Reply of the Surgeon General,” p. 726; Deloughery, pp. 75, 79; Flanagan, p. 39; Donahue, p. 327.
14. Cosmas, pp. 156, 160-61, 251-59, 264-70; O’Toole, pp. 12, 358-60; Jeanne Holm, Women in the Military: An Unfinished Revolution, rev. ed. (Novato, CA: Presidio Press, 1992), p. 8; Kalisch and Kalisch, pp. 234- 37; Aynes, p. 226; Dietz, p. 140; Friedel, pp. 295-96; Trask, p. 160.
15. Kalisch and Kalisch, p. 238.
16. Ibid., p. 241.
17. Shields, pp. 10-11; Donahue, pp. 327-33; Josephine A. Dolan, Nursing in Society: A Historical Perspective, 14th ed. (Philadelphia: W. B. Saunders Co., 1978), p. 221; Kalisch and Kalisch, p. 238.
18. Kalisch and Kalisch, pp. 238-241.
19. Ibid., p. 239.
20. Ibid., Pp. 239-40.
21. Ibid., p. 247; Senate, McGee Testimony, pp. 3168-80; O’Toole, pp. 12-13.
22. Ibid., p. 250; Goodnow, p. 192; Dietz, p. 140; Shields, pp. 10-11.
23. Senate, “Report of the Surgeon General,” p. 726.
24. Ibid., p. 171.
25. Holm, p. 9; Shields, pp. 12-14, 16; Dolan, pp. 285- 86; Dock et al., pp. 67, 70; Dietz, p. 141; Donahue, pp. 331, 333; Flanagan, p. 39; Goodnow, pp. 204, 243; Roberts, p. 30.
26. Shields, pp. 12-14; Dietz, p. 141; Holm, p. 9; Dolan, pp. 285-86; Donahue, pp. 331-33; Dock et al., p. 70; Flanagan, p. 39; Goodnow, pp. 204, 243; Roberts, p. 30.
27. ANM Papers, Library of Congress, “Another First for DAR,” pp. 247-48.